Patient Questionnaire

If you are a prospective patient, or know someone who could benefit from our services, please complete the printable form prior to your first visit. Completion of this questionnaire is purely voluntary but helps us expedite your admission to our facilities.
  • Patient Questionnaire Form (.pdf)
  • Kennesaw, GA 2017-05-22T11:14:12+00:00

    Kennesaw, GA Treatment Centers Of America

    1735 Tuscan Heights Blvd Suite-116
    Kennesaw, GA 30152
    Phone: 770-426-7810
    Fax:  770-426-7812

    Hours of Operation

    Mon-Fri: 6am-11am
    Saturday: 7am-9am
    Sunday: Closed

    Kennesaw Staff

    Clinical Director: Cynthia Jackson, MA, MS, CADCII
    Lead Nurse:
    Melanie Boutwell, RN